In-situ adjustable intraocular lens

ABSTRACT

The present disclosure provides an intraocular lens (IOL) or ophthalmic device including an optic and at least one haptic, at least a portion of which is formed from a photoresponsive shape memory polymer network, such as a polydomain azo liquid crystalline polymer network (PD-LCN). The present disclosure further provides systems and methods for adjusting the position of such an IOL or other ophthalmic device using polarized laser radiation.

PRIORITY CLAIM

This application claims the benefit of priority of U.S. ProvisionalPatent Application Ser. No. 62/831,520 titled “IN-SITU ADJUSTABLEINTRAOCULAR LENS,” filed on Apr. 9, 2019, whose inventors are XuweiJiang, Ali Akinay, Jingbo Liu, and Jian Liu, which is herebyincorporated by reference in its entirety as though fully and completelyset forth herein.

TECHNICAL FIELD

The present disclosure relates to an intraocular lens (IOL) for whichthe position may be adjusted in-situ in the capsular bag of the eye. Thepresent disclosure further relates to methods of adjusting the positionof such an IOL and a system for adjusting the IOL position.

BACKGROUND

The human eye includes a cornea and a crystalline lens that are intendedto focus light that enters the pupil of the eye onto the retina.However, the eye may exhibit various refractive errors, which result inlight not being properly focused upon the retina, and which may reducevisual acuity. Many interventions have been developed over the years tocorrect various ocular aberrations. These include spectacles, contactlenses, corneal refractive surgery, such as laser-assisted in situkeratomileusis (LASIK) or corneal implants, and IOLs. IOLs are also usedto treat cataracts by replacing the natural diseased crystalline lens ofthe eye of a patient. During typical IOL-placement surgery, an IOL isinserted into the capsular bag of a patient to replace the naturalcrystalline lens.

Whether implanted for refractive errors or for cataract treatment, anIOL may not always be located in the predicted position after surgery.In addition, the IOL may potentially shift, either rotationally oraxially or in combination, within the capsular bag over time, so that itis no longer in the predicted position. An improperly positioned IOL maynegatively impact the patient's quality of vision, as the location ofthe IOL in the eye impacts refractive power and, in applicable cases,astigmatic correction. Therefore, a predicted position of the IOL in theeye is used to develop a surgical plan and select a particular IOL for apatient. When the actual position of the IOL deviates from the predictedposition in the surgical plan, the outcome may be suboptimal.

SUMMARY

The present disclosure provides an intralocular-lens (IOL) including anoptic and at least one haptic, at least a portion of which is formedfrom a polydomain azo liquid crystalline polymer network (PD-LCN).

In further details, which may be combined with one another or with anyother portions of this disclosure in any combinations, unless clearlymutually exclusive, the disclosure further provides:

i) the at least one haptic may include a haptic junction, at least aportion of which is formed from PD-LCN;

ii) the at least one haptic may be attached to the optic via the hapticjunction;

iv) the IOL may further include a base which holds the optic and the atleast one haptic may be attached to the base;

v) the IOL may include a plurality of haptics and at least a portion ofeach may be formed from PD-LCN;

vi) each haptic may include a haptic junction, at least a portion ofwhich may be formed from PD-LCN;

vii) the PD-LCN may include crosslinked diacrylate liquid crystalmonomer and diacrylate azobezene liquid crystal monomer;

viii) the PD-LCN may include 25 wt % or less diacrylate azobenzeneliquid crystal monomer;

ix) the PD-LCN may have a crosslink density of between 1.0 mol/dm³ and8.0 mol/dm³;

x) the diacrylate liquid crystal monomer may include4-(3-Acryloyloxypropyloxy)-benzoesure 2-methyl-1,4-phenylester;

xi) the diacrylate azobezene liquid crystal monomer may include4,4′-bis[6-acryloloxy)hexyloxy]azobenzene;

xii) the diacrylate liquid crystal monomer may include4-(3-Acryloyloxypropyloxy)-benzoesure 2-methyl-1,4-phenylester and thediacrylate azobezene liquid crystal monomer may include4,4′-bis[6-acryloloxy)hexyloxy]azobenzene.

The present disclosure further provides an ophthalmic device including abase including an opening configured to receive an optic of anintra-ocular lens and at least one haptic coupled to the base, at leasta portion of the at least one haptic comprising a photoresponsive shapememory polymer network.

In further details, which may be combined with one another or with anyother portions of this disclosure in any combinations, unless clearlymutually exclusive, the disclosure further provides:

i) the photoresponsive shape memory polymer network may include apolydomain azo liquid crystalline polymer network (PD-LCN);

ii) the at least one haptic may include a haptic junction, at least aportion of which may be formed from the photoresponsive shape memorypolymer network;

iii) the at least one haptic may be attached to the optic via the hapticjunction;

iv) the at least one haptic may include a plurality of haptics and atleast a portion of each may be formed from the photoresponsive shapememory polymer network;

v) the PD-LCN may include crosslinked diacrylate liquid crystal monomerand diacrylate azobezene liquid crystal monomer;

vi) the PD-LCN may include 25 wt % or less diacrylate azobenzene liquidcrystal monomer;

vii) the PD-LCN may have a crosslink density of between 1.0 mol/dm³ and8.0 mol/dm³.

viii) the diacrylate liquid crystal monomer may include4-(3-Acryloyloxypropyloxy)-benzoesure 2-methyl-1,4-phenylester;

ix) the diacrylate azobezene liquid crystal monomer may include4,4′-bis[6-acryloloxy)hexyloxy]azobenzene;

x) the diacrylate liquid crystal monomer may include4-(3-Acryloyloxypropyloxy)-benzoesure 2-methyl-1, 4-phenylester and thediacrylate azobezene liquid crystal monomer comprises4,4′-bis[6-acryloloxy)hexyloxy]azobenzene;

The present disclosure may include a method of adjusting an IOL or anophthalmic device. The IOL or ophthalmic device may be any IOL orophthalmic device described above or elsewhere in this disclosure. Themethod may include irradiating a portion of a haptic of the IOL orophthalmic device, in which the haptic includes a photoresponsive shapememory polymer network, such as PD-LCN, with polarized laser radiationto cause the photoresponsive shape memory polymer network, such asPD-LCN, to bend to a bending angle, thereby pushing against a capsularbag in which the IOL or ophthalmic device is located and adjusting theposition of the IOL or ophthalmic device in the capsular bag.

In further details, which may be combined with one another or with anyother portions of this disclosure in any combinations, unless clearlymutually exclusive, the disclosure further provides:

i) the polarized laser radiation may have a wavelength in the range of440 nm to 514 nm, including the endpoints;

ii) the position of the IOL may be adjusted axially forward or backward;

iii) the position of the IOL may be adjusted radially by an angle;

iv) the IOL may be in an actual position in the capsular bag that isdifferent from a target position, and adjusting the position of the IOLmay include moving the IOL to the target position;

v) irradiating may occurs for from between 0.5 seconds and 5 minutes,including the endpoints.

The present disclosure provides a method of correcting refractive error.The method includes implanting, in the eye of a patient, an IOL orophthalmic device including at least one haptic, at least a portion ofthe at least one haptic including a photoresponsive shape memory polymernetwork, obtaining post-surgical biometric data for the eye of thepatient, determining a post-surgical refractive error of the eye of thepatient, based on the post-surgical biometric data and post-surgicalrefractive error, generating a nomogram to control a laser to applypolarized laser radiation to the photoresponsive shape memory polymernetwork to induce a shape change of the haptics and thereby cause theintraocular lens to at least one of translate or rotate in the eye ofthe patient, thereby correcting the post-surgical refractive error, andirradiating the photoresponsive shape memory polymer network using thelaser. The IOL or ophthalmic device may be any IOL or ophthalmic devicedescribed above or elsewhere in this disclosure.

In further details, which may be combined with one another or with anyother portions of this disclosure in any combinations, unless clearlymutually exclusive, the disclosure further provides:

i) the photoresponsive shape memory polymer network comprises a PD-LCN;

ii) the polarized laser radiation may have a wavelength in the range of440 nm to 514 nm, including the endpoints;

iii) the position of the IOL may be adjusted axially posteriorly oranteriorly;

iv) the position of the IOL may be adjusted radially by an angle θ;

v) irradiating may occur for from between 0.5 seconds and 5 minutes,including the endpoints;

vi) the irradiated portion of the haptic comprising the PD-LCN mayinclude a haptic junction.

The present disclosure further provides a surgical system for adjustingthe position of an IOL or ophthalmic device, such as any IOL orophthalmic device described above or elsewhere in this disclosure. Thesystem includes a laser able to provide laser radiation in the range of440 nm to 514 nm, including the endpoints, a polarization filter able toadjust the angle or polarization of radiation from the laser, and acomputer comprising a processor, a memory, and a communicationsinterface, in which the computer is able to execute, using theprocessor, instructions stored in the memory to cause instructions to besent through the communications interface to cause the laser and thepolarization filter to irradiate at least a portion of a haptic of anIOL or ophthalmic device located in the capsular bag of an eye of apatient with polarized laser radiation, wherein the irradiated portionincludes a photoresponsive shape memory polymer network comprises, suchas a PD-LCN, and bends to a bending angle in response to the radiation.The instructions may include all or part of any method described aboveor otherwise disclosed herein.

In further details, which may be combined with one another or with anyother portions of this disclosure in any combinations, unless clearlymutually exclusive, the disclosure further provides:

i) the irradiated portion of the haptic includes a haptic junction;

ii) the laser may include a femtosecond laser or an excimer laser.

BRIEF DESCRIPTION OF THE DRAWINGS

For a more complete understanding of the present disclosure, referenceis now made to the following description, taken in conjunction with theaccompanying drawings illustrating aspects of the present disclosure, inwhich like components have like numerals, including with alphabeticdesignations of variants, such as 10 a, 10 b, and in which:

FIG. 1A is a schematic top view diagram of a single-piece IOL having twohaptics;

FIG. 1B is a schematic side-view diagram of the single-piece IOL of FIG.1A;

FIG. 1C is a schematic side-view diagram of the single-piece IOL of FIG.1A and FIG. 1B with the PD-LNC bent to approximately a 40° bendingangle.

FIG. 2A is a schematic top view diagram of a two-piece IOL;

FIG. 2B is a schematic side-view diagram of the two-piece IOL of FIG.2A;

FIG. 3 is a schematic top view diagram of a single-piece IOL havingthree haptics;

FIG. 4 is a schematic top view diagram of a single-piece IOL having fourhaptics;

FIG. 5 is a schematic top view diagram of a single-piece IOL having twohaptics with a complex structure;

FIG. 6 is a schematic top view diagram of a single-piece IOL having twolooped haptics;

FIG. 7 is a schematic perspective view diagram of a single-piece IOLhaving two three-dimensional haptics;

FIG. 8 is a flow chart of a method of implanting and adjusting an IOL;

FIG. 9 is an example graph of the relationship between PD-LCN bendingangle and polarization angle of laser radiation;

FIG. 10 is a diagram of a surgical system for adjusting the position ofan IOL.

DETAILED DESCRIPTION

The present disclosure relates to an intraocular lens (IOL) for whichthe position may be adjusted in-situ. The present disclosure furtherrelates to methods of adjusting the position of such an IOL and a systemfor adjusting the IOL position. In particular, an IOL of the presentdisclosure may include at least one haptic, at least a portion of whichis formed from a photoresponsive shape memory polymer network, such as apolydomain azo liquid crystalline polymer network (PD-LCN). The PD-LCNwill predictably bend in a given direction in response to a particularwavelength of laser radiation with a particular polarization, allowingadjustments to the IOL position within the eye. In addition, the PD-LCNwill retain its shape so that the adjusted IOL position is retained.Further, PD-LCN bending and thus IOL position adjustment is reversiblein response to a different polarization of the laser radiation.

An IOL of the present disclosure may be a single-piece or modular IOL(e.g., a two-piece or three-piece IOL). In general, an IOL includes atleast one optic and at least one haptic. The haptic is located on theside(s) of the optic and helps maintain the IOL in a stable positionwithin the eye. Depending on the IOL design, the haptic may beintegrated with or directly coupled to the optic. In some designs, theIOL may also include a separate or integral base with which the opticand/or haptics may be integrated or coupled. The base may hold theoptic, and the haptic may be attached to the base. The region of thehaptic that attaches to the optic or the base is referred to herein asthe haptic junction. Components of a modular IOL may be individuallyinserted and assembled within the eye during surgery.

The entire haptic, a portion thereof, or only the haptic junction may beformed from PD-LCN. Some IOLs of the present disclosure may include aplurality of haptics. In such a case, all of the haptics may include atleast a portion formed from PD-LCN. For example, all of the haptics mayhave a haptic junction formed from PD-LCN. In some IOLs with a pluralityof haptics, symmetrically placed haptics, such as haptics opposite oneanother or haptics at 120 degree angles may have the same placements ofPD-LCN, to allow symmetrical adjustment of IOL position. In addition, insome IOLs with a plurality of haptics, set of haptics, particularly setswhose members are symmetrically placed, may have different placements ofPD-LCN to allow the haptics to respond differently to polarized laserradiation, allowing more fine-tuned adjustment of IOL position.

All IOLs occasionally experience improper placement, so the presentdisclosure is compatible with any type of IOL. Specific IOLs aredescribed in FIGS. 1-7 to demonstrate how PD-LCN may be used in IOLs.One of ordinary skill in the art, with the benefit of the presentdisclosure, may determine an appropriate placement of PD-LCN in manyother types of IOLs in addition to those specifically illustrated.

FIG. 1A is a schematic diagram of an IOL 10 a including an optic 20 aand two haptics 30 a attached to the optic 20 a and/or a base (notshown). Each of the haptics 30 a has an arm 40 a and a haptic junction50 a between the arm 40 a and the optic 20 a. The haptic junction 50 amay attach the haptic 30 a to the optic 20 a (or base). The IOL also hasa center 60 a. Once it is implanted and secure in the capsular bag, theIOL 10 a may be rotated around the center 60 a in a direction 70 or adirection 80 by an angle θ by irradiating one or more of the hapticjunctions 50 a to cause the PD-LNC to change shape. As illustrated inFIG. 1B, the IOL 10 a may also move forward (anteriorly) in the eye indirection 90 or backward (posteriorly) in the eye direction 100. FIG. 1Cshows the IOL 10 a, after both haptic junctions 50 a have beenirradiated to cause the PD-LNC to bend to approximately a 40° bendingangle, pushing the IOL backward (posteriorly) in the eye in direction100.

FIG. 2A is a schematic diagram of an IOL 10 b including an optic 20 band two haptics 30 b that are attached to the optic 20 b or base (notshown). Each of the haptics 30 b has an arm 40 b and a haptic junction50 b between the arm 40 b and the optic 20 b. After it is implanted andsecure in the capsular bag, the optic of IOL 10 b can be rotated aroundthe center 60 b in a direction 70 or a direction 80 by an angle θ.Additionally, as shown in FIG. 2B, the optic 20 b of IOL 10 b can beadjusted anteriorly or posteriorly in the eye in directions 90 or 100,respectively, by irradiating the haptic junctions 50 b to cause thePD-LNC to change shape. FIG. 2B also illustrates how the optic 20 b maybe positioned within a base 110, in accordance with some embodiments ofa two-piece IOL.

FIG. 3 is a schematic diagram of another IOL 10 c including an optic 20c and three haptics 30 c attached to the optic 20 c or base (not shown).Each of the haptics 30 c has an arm 40 c and a haptic junction 50 cbetween the arm 40 c and the optic 20 c. The haptic junction 50 c mayattach the haptic 30 c to the optic 20 c. The IOL also has a center 60c. After it is implanted and secure in the capsular bag, the optic ofIOL 10 c can be rotated around the center 60 c in a direction 70 or adirection 80 by an angle θ and/or adjusted posteriorly or anteriorly inthe eye by irradiating one or more of the haptic junctions 50 c to causethe PD-LNC to change shape.

FIG. 4 is a schematic diagram of another IOL 10 d including an optic 20d and four haptics 30 d attached to the optic 20 d or a base (notshown). Each of the haptics 30 d has an arm 40 d and a haptic junction50 d-1 or 50 d-2 between the arm 40 d and the optic 20 d. Each hapticjunction 50 d-1 or 50 d-2 may attach the haptic 30 d to the optic 20 dor base. The IOL also has a center 60 d. After it is implanted andsecure in the capsular bag, the optic of IOL 10 d can be rotated aroundthe center 60 d in a direction 70 or a direction 80 by an angle θ and/oradjusted posteriorly or anteriorly in the eye by irradiating one or moreof the haptic junctions 50 d-1 and/or 50 d-2 to cause the PD-LNC tochange shape. Haptic junctions 50 d-1 may be formed from the same PD-LCNas haptic junctions 50 d-2 or from a different PD-LCN. For examplehaptic junctions 50 d-1 may have a different wt % of diacrylateazobenzene liquid crystal monomer or a different crosslink density thanhaptic junctions 50 d-2, allowing the haptic junctions to responddifferently to polarized laser radiation.

FIG. 5 is a schematic diagram of another IOL 10 e including an optic 20e and two haptics 30 e attached to the optic 20 e or base (not shown).Both of the haptics 30 e has an arm 40 e and a haptic junction 50 ebetween the arm 40 e and the optic 20 e. The haptic junction 50 e mayattach the haptic 30 e to the optic 20 e. The IOL also has a center 60e. After it is implanted and secure in the capsular bag, the optic 20 eof IOL 10 e can be rotated around the center 60 e in a direction 70 or adirection 80 by an angle θ and/or adjusted posteriorly or anteriorly inthe eye by irradiating one or more of the haptic junctions 50 e to causethe PD-LNC to change shape.

FIG. 6 is a schematic diagram of another IOL 10 f including an optic 20f and two looped haptics 30 f attached to the optic 20 f or a base (notshown). Each of the haptics 30 f has an arm 40 f and at least one hapticjunction 50 f between the arm 40 f and the optic 20 f. The hapticjunction 50 f may attach the haptics 30 f to the optic 20 f. The IOLalso has a center 60 f After it is implanted and secure in the capsularbag, the optic 20 f of IOL 10 f can be rotated around the center 60 f ina direction 70 or a direction 80 by an angle θ and/or adjustedposteriorly or anteriorly in the eye by irradiating one or more of thehaptic junctions 50 f to cause the PD-LNC to change shape.

FIG. 7 is a schematic diagram of another IOL 10 g including an optic 20g and two three-dimensional haptics 30 g attached to the optic 20 g or abase (not shown). Each of the haptics 30 g has an arm 40 g, which inthis example has a complex three-dimensional structure, and at least onehaptic junction 50 g between the arm 40 g and the optic 20 g. The hapticjunctions 50 g may attach the haptics 30 g to the optic 20 g. The IOLalso has a center 60 g. After it is implanted and secure in the capsularbag, the optic of IOL 10 g can be rotated around the center 60 g in adirection 70 or a direction 80 by an angle θ and/or adjusted posteriorlyor anteriorly in the eye by irradiating one or more of the hapticjunctions 50 g to cause the PD-LNC to change shape.

In FIGS. 1A-7 , the entire haptic 30 may be formed from PD-LCN, or onlya portion thereof may be formed from PD-LCN. In particular, the hapticjunction 50 may be formed from PD-LCN and attached to both the remainingportion of the haptic 30, such as the arm 40, and the optic 20 or thebase 110. In addition, the haptic 30 or the haptic junction 50 may beformed from more than one type of PD-LCN. For example, the PD-LCN indifferent portions of the haptic 30 or the haptic junction 50 may varyin composition or in crosslink density to provide different degrees ofresponsiveness to polarized laser radiation.

The PD-LCN suitable for use in the present disclosure may be anybiocompatible PD-LCN that bends in response to exposure to polarizedlaser radiation in the range of 440 nm to 514 nm, in the range of 457 nmto 514 nm, or in the range of 440 nm to 445 nm, with the rangesincluding the endpoints, or particularly 442 nm.

The PD-LCN may include crosslinked diacrylate liquid crystal monomer anddiacrylate azobezene liquid crystal monomer. The diacrylate azobenzeneliquid crystal monomer may be present in an amount of 25 wt % or less,20 wt % or less, 15 wt %, or less, 10 wt % or less, 5 wt % or less,between 0.1 wt % and 25 wt % between 0.1 wt % and 20 wt %, between 0.1wt % and 15 wt %, between 0.1 wt % and 10 wt %, between 0.1 wt % and 5wt %, between 1 wt % and 25 wt %, between 1 wt % and 20 wt %, between 1wt % and 15 wt %, between 1 wt % and 10 wt %, between 1 wt % and 5 wt %,between 3 wt % and 25 wt %, between 3 wt % and 20 wt %, between 3 wt %and 15 wt %, between 3 wt % and 10 wt %, between 3 wt % and 5 wt %,between 5 wt % and 25 wt %, between 5 wt % and 20 wt %, between 5 wt %and 15 wt %, between 5 wt % and 10 wt %, between 10 wt % and 25 wt %,between 10 wt % and 20 wt %, between 10 wt % and 15 wt %, between 15 wt% and 25 wt %, between 15 wt % and 20 wt %, or between 20 wt % and 25 wt%, where ranges between two amounts include the endpoints.

PD-LCNs with lower crosslink density exhibit a more pronounced bendingresponse upon exposure to polarized laser radiation than PD-LCNs withhigher crosslink density. For many IOLs, a more pronounced bendingresponse is desired to limit the amount of time it takes to induce theresponse. However, for IOLs where more controlled bending is useful,PD-LCN crosslink density may be increased. In addition, some degree ofcrosslinking is needed to form a stable PD-LCN.

The crosslink density may be affected by formation conditions,particularly the length of photocuring the monomers in the presence ofone another to induce crosslinking. In addition, the crosslink densitymay be influenced by the molecular weights of the monomers, with lowermolecular weight monomers producing PD-LCN with a higher crosslinkdensity, all other factors being equal.

Typically, the PD-LCN used in the haptic 30 or the haptic junction 50will have a crosslink density of between 1.0 mol/dm3 and 8.0 mol/dm3.

One suitable diacrylate liquid crystal monomer for use in the presentdisclosure is 4-(3-Acryloyloxypropyloxy)-benzoesure 2-methyl-1,4-phenylester (also known as 2-Methylbenzene-1,4-diylbis{4-[3-(acryloyloxy)propoxy]benzoate}), which has the followingstructural formula:

Suitable diacrylate azobezene liquid crystal monomers for use in thepresent disclosure include 4,4′-bis[6-acryloloxy)hexyloxy]azobenzene,which has the following structural formula:

as well as diacrylates of 4-heptyl 4′-propylazobenzene, 4-octyl4′-propylazobenzene, 4-cyano 4′-heptyloxyazobenzene, and 4-cyano4′-octyloxyazobenzene.

Although PD-LCN is discussed in detail as an example of aphotoresponsive shape memory polymer network, other photoresponsiveshape memory polymer networks may be used in the same manner as PD-LCN.For example, a photoresponsive shape memory polymer network with one ormore crosslinkers other than a diacrylate or with different monomers maybe used. In photoresponsive shape memory polymer network including aPD-LCN, an additive may be used. In general, the photoresponsive shapememory polymer network need only bend in a predictable way, such as at apredictable bending angle, in response to polarized laser radiation,particularly to polarized laser radiation with a given polarizationangle.

The present disclosure further provides a method 200 of implanting andadjusting an IOL, such as IOL 10, containing a photoresponsive shapememory polymer network, such as PD-LCN, in an eye of a patient as shownin the flowchart of FIG. 8 . In step 210, the lens (which is typically anatural lens, but may be a prior IOL) is removed from the capsular bag.In step 220, the IOL is placed in the capsular bag. During this step,the surgeon attempts to place the IOL in a selected position, but doesnot always succeed in doing so. In step 230, the eye is allowed to healfor a duration of time, typically two to four weeks. The IOL may move orchange position within the eye during this time.

In step 240, the patient undergoes a diagnostic eye exam, typicallydays, weeks, or months after surgery to obtain post-surgical data. Instep 240, biometric data of the eye may be obtained. In step 240,quality of vision data, such a refractive error, including simplerefraction measurement or, where appropriate more complex measurements,such as axis of astigmatism, may also be obtained. Step 240 may also beinitiated as an IOL maintenance step, often weeks, months, or yearsafter initial IOL placement.

In step 250, based at least in part on information from the diagnosticeye exam, such as post-surgical biometric data and post-surgicalrefractive error it is determined whether the patient's quality ofvision may be improved. For example, the patient may experiencesub-optimal refraction in the eye, or may still experience astigmatism.The diagnostic eye exam may, for example measure refraction or cylinderusing, for example, a refractometer or an aberrometer.

In step 250, based on data from the diagnostic eye exam, such aspost-surgical biometric data and post-surgical refractive error, anomogram may be generated to control a laser to apply polarized laserradiation to a photoresponsive shape memory polymer network, such asPD-LCN, to induce a shape change of the haptics and thereby cause theintraocular lens to at least one of translate or rotate in the eye ofthe patient, thereby correcting the post-surgical refractive error. Thenomogram may, for example, be used to determine an angle of bending ofthe photoresponsive shape memory polymer network, such as PD-LCN, andthe polarized laser radiation, including the polarization angle, thatwill achieve the angle of bending. Alternatively, a non-nomogram-basedalgorithm may be used to control the laser in the same fashion. Thenomogram may be generated or the non-nomogram-based algorithm may beexecuted using a programmed computer, which may also be able to receiveand store data from the diagnostic eye exam.

In step 260, polarized laser radiation with a polarization angle and fora time sufficient to cause the portion of the IOL to bend is applied toat least a portion of an IOL haptic containing the photoresponsive shapememory polymer network, such as PD-LCN, adjusting the position of theIOL in the capsular bag.

The portion of the IOL containing the photoresponsive shape memorypolymer network, such as PD-LCN, that is irradiated may be the hapticjunction, or another part of the haptic that can be reached viapolarized laser radiation when the pupil of the eye is dilated.Accordingly, before the portion of the IOL haptic containing thephotoresponsive shape memory polymer network, such as PD-LCN, isirradiated with polarized laser radiation, the pupil of the patient'seye may be dilated to allow access to the photoresponsive shape memorypolymer network, such as PD-LCN. In methods where the portion of the IOLcontaining photoresponsive shape memory polymer network, such as PD-LCN,is normally covered by the pupil and not exposed to light, there may notbe a need for the patient to wear protective glasses after any surgicalprocedures to implant or adjust the position of the IOL.

The polarized laser radiation may be provided by any laser able tosupply a wavelength able to cause bending of the photoresponsive shapememory polymer network, such as PD-LCN, when passed through apolarization filter. For example, the laser may be a femtosecond orexcimer laser. The wavelength may be in the range of 440 nm to 514 nm,in the range of 457 nm to 514 nm, or in the range of 440 nm to 445 nm,with the ranges including the endpoints, or particularly 442 nm.

The polarization filter may be part of the laser, or otherwise placedbetween the laser and the eye using suitable optics.

The polarization angle may be selected based on the degree of bending ofthe photoresponsive shape memory polymer network, such as PD-LCN, to beachieved. As illustrated in FIG. 9 , a thin strip of PD-LCN, such as maybe contained in the haptic, will bend a predictable angle in response toa particular degree of polarized laser radiation. This bending angle andpolarization angle relationship tends to be linear. The responsivenessof the bending angle may be determined, in part, by the crosslinkdensity of the PD-LCN.

Irradiation with the polarized laser continues for an amount of timedetermined to be appropriate to achieve the target bending angle. Forexample, the amount of time may be 5 minutes or less, 2 minutes or less,one minute or less, between 0.5 seconds and 1 minute, between 0.5seconds and 2 minutes, between 0.5 seconds and 5 minutes, between 5seconds and 1 minute, between 5 seconds and 2 minutes, or between 5seconds and 5 minutes, where ranges between two amounts include theendpoints. Irradiation may be constant or pulsed.

The same haptic may be irradiated more than once to obtain the correctbending angle. In addition, although only one haptic may be irradiated,for many adjustments, more than one or all haptics will be irradiated.

Depending on the physical shape of the portion of the haptic irradiated,which haptics are irradiated, the position of the haptic(s) in thecapsular bag, and the degree of photoresponsive shape memory polymernetwork, such as PD-LCN, bending induced, the IOL will move to anadjusted position within the capsular bag.

For example, if the haptics of the IOL are subjected to laser radiationat a polarization angle that causes the haptics to push against theposterior region of the capsular bag, the IOL will be moved axiallyforward in the capsular bag, to a position that is more anterior in theeye. If the haptics of the IOL are subjected to laser radiation at apolarization angle that causes the haptics to push against the anteriorregion of the capsular bag, the IOL will be moved axially backward inthe capsular bag, to a position that is more posterior in the eye. Thesesimple forward and backward axial adjustments may change the diopter ofthe IOL, and correct refractive errors.

More complex IOLs may bend to push against different portions of thecapsular bag, or to internally rotate, allowing rotation of the IOLoptic around a center by a target angle. This may be useful, forexample, when the patient has astigmatism and the IOL is not properlyaligned with the axis of astigmatism.

The location and degree of bending and the polarization angle may becalculated using a computer programmed to access data regarding the eyeand the IOL, to calculate the effects of laser irradiation on bendingand location of the IOL optic, and to select an appropriate location andduration of laser radiation to achieve the target position of the IOL.

The location and duration of laser radiation and, in some systems, alsothe placement of the polarization filter and thus the polarization anglemay also be implemented using a computer programmed to control thelaser. The computer may be the same as the computer programmed tocalculate how to achieve the target position of the IOL, or a differentcomputer.

For purposes of this disclosure, a computer includes a processor,memory, and a communications interface.

In step 270, the eye is allowed to recover for a duration of timesufficient to then obtain accurate eye exam results. Typically the pupilis dilated prior to step 260, so the duration of time may be at leastlong enough for pupil dilation to cease. For example, the duration oftime may be at least a day or at least a week.

The process then returns to step 240 and the patient is again evaluatedto determine if the actual IOL position is the target position.

Although method 200 is described with multiple steps, the disclosureincludes other methods encompassing only a portion of those steps, suchas steps 240 through 260, or steps 250 through 270.

After bending, the photoresponsive shape memory polymer network, such asPD-LCN, remains in position indefinitely, making adjustments usingmethod 200 permanent unless the IOL shifts due to other causes. However,the photoresponsive shape memory polymer network, such as PD-LCN, canreadily be bent multiple times to different degrees by irradiating thephotoresponsive shape memory polymer network, such as PD-LCN, with laserradiation having a different polarization angle. So, for example, if theIOL optic is moved too far forward in the eye in step 260, the samehaptic may be irradiated with laser radiation at a differentpolarization angle, causing it to bend to a lesser degree, effectivelymoving the IOL optic backwards in the eye.

The present disclosure further includes a surgical system 300, asillustrated in FIG. 10 , for adjusting the position of an IOL, such asan IOL 10, in the capsular bag of an eye. The system 300 includes acomputer 310, which includes a processor 320, a memory 330, and acommunications interface 340. The system 300 also includes a laser 350which is able to provide laser radiation in a suitable range to induceshape change in the haptic material, such as in the range of 440 nm to514 nm, in the range of 457 nm to 514 nm, or in the range of 440 nm to445 nm, with the ranges including the endpoints, or particularly 442 nm.System 300 may further include a polarization filter 360, which is ableto adjust the polarization angle of radiation from the laser 350. Thepolarization filter 360 may be part of the laser 350, or a separatecomponent.

The computer 310 may include in the memory 330 instructions that, whenexecuted by the processor 320, cause instructions to be sent through thecommunications interface 340 to cause the laser 350 and the polarizationfilter 360 to irradiate certain portions of the IOL, in the capsular bagof a patient's eye, to cause the photoresponsive shape memory polymernetwork, such as PD-LCN, of the IOL to bend. In particular, when theinstructions are executed by the processor 320, they may cause the laser350 and the polarization filter 360 to implement step 260 of method 200.Additionally, memory 330 may store instructions for generating, based onpatient-specific biometric, wavefront, and/or other measurements takenpost-surgery, an algorithm or nomogram to cause laser 350 to apply lightto the haptics so as to induce a shape change which will cause the lensto change position and thereby correct any residual refractive errorand/or toric misalignment.

The above disclosed subject matter is to be considered illustrative, andnot restrictive, and the appended claims are intended to cover all suchmodifications, enhancements, and other embodiments which fall within thetrue spirit and scope of the present disclosure. Thus, to the maximumextent allowed by law, the scope of the present disclosure is to bedetermined by the broadest permissible interpretation of the followingclaims and their equivalents, and shall not be restricted or limited bythe foregoing detailed description.

The invention claimed is:
 1. An in-situ adjustable intraocular lens(IOL) comprising: an optic; and at least one haptic attached to theoptic via a haptic junction, at least a portion of the haptic junctionis formed from a photoresponsive shape memory polymer network, whereinsaid photoresponsive shape memory polymer network comprises a polydomainazo liquid crystalline polymer network (PD-LCN), wherein, the IOL isconfigured to be positioned in a capsular bag of a patient, and furtherconfigured such that irradiation of the haptic junction with polarizedlaser radiation induces a shape change of the polydomain azo liquidcrystalline polymer network, and therefore a shape change of the atleast one haptic, to cause the IOL to translate or rotate in thecapsular bag.
 2. The IOL of claim 1, wherein the IOL further comprises abase configured to hold the optic, and the at least one haptic isattached to the base.
 3. The IOL of claim 1, wherein the IOL comprises aplurality of haptics and at least a portion of each of the plurality ofhaptics comprises PD-LCN.
 4. The IOL of claim 1, wherein the PD-LCNcomprises crosslinked diacrylate liquid crystal monomer and diacrylateazobezene liquid crystal monomer.
 5. The IOL of claim 4, wherein thePD-LCN comprises 25 wt % or less diacrylate azobenzene liquid crystalmonomer.
 6. The IOL of claim 4, wherein the PD-LCN has a crosslinkdensity of between 1.0 mol/dm³ and 8.0 mol/dm³.
 7. The IOL of claim 4,wherein the diacrylate liquid crystal monomer comprises4-(3-Acryloyloxypropyloxy)-benzoesure 2-methyl-1,4-phenylester.
 8. TheIOL of claim 4, wherein the diacrylate azobezene liquid crystal monomercomprises 4,4′-bis[6-acryloloxy)hexyloxy]azobenzene.
 9. The IOL of claim1, wherein the polarized laser radiation has a wavelength in the rangeof 440 nm to 514 nm.
 10. The IOL of claim 1, wherein the position of theIOL is adjusted axially anteriorly or posteriorly.
 11. The IOL of claim1, wherein the position of the IOL is adjusted radially by an angle 0.